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唐氏综合征成年患者的阻塞性睡眠呼吸暂停

Obstructive sleep apnea in adults with Down syndrome.

作者信息

Landete Pedro, Soriano Joan B, Aldave Beatriz, Zamora Enrique, Acosta Carmen, Erro Marta, López Riolobos Cristina, Ramos M Inmaculata, Moldenhauer Fernando, Ancochea Julio

机构信息

Department of Pneumology, Hospital Universitario de La Princesa, Madrid, Spain.

Medical Department, Linde Healthcare Spain, Madrid, Spain.

出版信息

Am J Med Genet A. 2020 Dec;182(12):2832-2840. doi: 10.1002/ajmg.a.61853. Epub 2020 Sep 10.

Abstract

Patients with Down syndrome (DS) often have a high occurrence of obstructive sleep apnea-hypopnea (OSA) syndrome. We studied a large cohort of adults with DS attended due to clinical suspicion of OSA. A standardized questionnaire and full medical assessment were conducted, including a sleep study. One hundred and fifty-seven DS individuals were studied, with a mean ± SD age of 36 ± 10 years, 40.7% women, BMI 29.4 ± 5.6 kg/m . The main clinical symptom was daytime sleepiness (64.9%). A sleep study was conducted in 114 patients. All 114 DS patients were diagnosed with OSA, with a predominance of obstructive and hypopnea events, (apnea-hypopnoea index, AHI, 35.0 ± 26.6), with an oxygen desaturation index of 32.9, and a Tc90% of 24.7%. Continuous positive airway pressure (CPAP) treatment was implemented in 75 (65.8%) of subjects. Tolerance was considered good in 75% of them, with a high compliance of 79.2% >4 hr/day (mean 7.1 hr/day), resulting in a symptomatic improvement in 58.7% of them. Obstructive sleep apnea is frequently confirmed in patients with DS when it clinically suspected. Treatment with CPAP in DS is feasible, and with higher adherence than in adults with normal cognitive functioning.

摘要

唐氏综合征(DS)患者常高发阻塞性睡眠呼吸暂停低通气(OSA)综合征。我们研究了一大群因临床怀疑患有OSA而前来就诊的成年DS患者。进行了标准化问卷调查和全面的医学评估,包括睡眠研究。共研究了157名DS患者,平均年龄±标准差为36±10岁,女性占40.7%,体重指数(BMI)为29.4±5.6kg/m²。主要临床症状为日间嗜睡(64.9%)。对114名患者进行了睡眠研究。所有114名DS患者均被诊断为OSA,以阻塞性和低通气事件为主(呼吸暂停低通气指数,AHI,35.0±26.6),氧饱和度下降指数为32.9,最低血氧饱和度(Tc90%)为24.7%。75名(65.8%)受试者接受了持续气道正压通气(CPAP)治疗。其中75%的患者耐受性良好,依从性高,79.2%的患者每天使用时间>4小时(平均每天7.1小时),58.7%的患者症状得到改善。当临床上怀疑DS患者患有阻塞性睡眠呼吸暂停时,常可得到确诊。DS患者使用CPAP治疗是可行的,且依从性高于认知功能正常的成年人。

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